Caspofungin salvage therapy in pneumocystis jirovecii pneumonia

Abstract pneumocystis jirovecii pneumonia (PJP) is a severe complication and leading cause of deaths among human immunodeficiency virus (HIV)-infected patients. Although trimethoprim/sulfamethoxazole (TMP/SMZ) is well known for its effectiveness as empiric and target therapy, but TMP/SMZ is associated with various side effects (including skin rash, leucopenia, hepatitis and diarrhea). The clinical evidence of synergistic activity of caspofungin to TMP/SMZ or salvage treatment of PJP is controversy till now. Here, we report a HIV-infected patient complicated with PJP, he suffered from skin rash and leucopenia after TMP/SMZ treatment for 6 days. Therefore the treatment regimen was replaced by caspofungin. The patient was discharged from the hospital in good condition after a 14 days of caspofungin salvage therapy.